178 Turk Neurosurg 30(2):178-181, 2020 ABSTRACT AIM: To investigate the magnetic resonance imaging (MRI) results of patients complaining from diplopia with ocular nerve palsy. MATERIAL and METHODS: A routine ophthalmic examination was performed, a neurological consultation was requested, and cranial MRI was performed for all patients. The image results were sorted into four groups: ischemic lesions, demyelinating disease lesions, tumors, and no lesions. White matter gliosis and cerebral infarcts were included in the ischemic lesion group. The medical histories of the patients were acquired from medical records. The chi-squared test was used to analyze the relationship between age and cranial MRI images and to analyze the relationship between the image and paresis type. The statistical signifcance threshold was set at p<0.05, unless otherwise stated. RESULTS: Ischemic MRI images were the most common image type seen in our study. Third nerve paresis was signifcantly correlated with ischemic cerebral lesions observed by MRI (p=0.009). Furthermore, lesions were signifcantly correlated with patients aged above 50 years (p=0.004). There were no signifcant correlations between fourth or sixth nerve paresis and cranial ischemic images (p=0.680 and p=0.678, respectively). There were two instances of cerebral artery aneurysm, three instances of cerebral infarct, and one instance of intracranial mass, all in patients aged over 50 years. CONCLUSION: Although our patients had minimal or nonexistent neurological symptoms, some had serious cranial pathologies. These pathologies were commonly seen in patients aged over 50 years. We recommend performing MRI on all patients with binocular diplopia. KEYWORDS: Magnetic resonance imaging, Diplopia, Cranial nerve diseases MRI Results of Patients with Acute Isolyted Cranial Nerve Palsies Hakan BAYBORA 1 , Faruk KAYA 1 , Ibrahim KOCAK 1 , Yunus KARABELA 2 1 Medipol University, Esenler Hospital, Department of Ophthalmology, Istanbul, Turkey 2 Bagcilar Research and Education Hospital, Department of Ophthalmology, Istanbul, Turkey Received: 13.10.2018 Accepted: 14.12.2018 Published Online: 27.02.2019 Corresponding author: Hakan BAYBORA  byretina@gmail.com Original Investigation █ INTRODUCTION D iplopia is a very serious condition in adults. Ocular, orbital, and central nervous system diseases are among the causes behind this condition. In diplopia with restrictive strabismus, most cases are of congenital, endocrine, postparalytic, traumatic, or myopathic origin (3). Monocular diplopia can be seen in ocular media opacities and diseases of the macula. The diagnosis of these conditions is out of the scope of this study. Magnetic resonance imaging (MRI) is an efective and safe method for the diagnosis of the underlying pathology behind acute acquired binocular diplopia (10). The technology of MRI is very suitable for detecting brain demyelination, infarction, infections, and neoplasms (9). However, performing this procedure in every patient with diplopia is controversial because of its cost (5). In this study, we aimed to analyze cranial MRI results from adult patients complaining from acute double vision, who were diagnosed with cranial nerve palsy. In doing so, we wanted to analyze the relationships between diferent palsies and the corresponding image results and determine whether MRI should be mandatory for every patient. Hakan BAYBORA : 0000-0002-9893-7904 Faruk KAYA : 0000-0001-9941-0031 Ibrahim KOCAK : 0000-0001-5650-3246 Yunus KARABELA : 0000-0002-2267-6656 DOI: 10.5137/1019-5149.JTN.24775-18.4